In the public hospital setting, the economic evaluation of molecular diagnostics cannot be reduced to the cost of the reagent or cartridge alone. The key factor is the cost of the entire diagnostic and care pathway: turnaround time, bed occupancy, isolation, therapeutic appropriateness, sample transport, central laboratory work and the organisational impact on wards. From this perspective, decentralised multiplex qPCR platforms deserve attention because they bring testing closer to the patient and reduce a significant portion of the indirect costs generated by centralised workflows.[2] [3]

Within the new three-division structure of Helyx Industries S.p.A., this area falls under the Vytro Division, dedicated to multiplex solutions for clinical and hospital settings, with the Hyris System™ serving as the enabling technology platform where applicable. In a peer-reviewed evaluation of the Hyris system for SARS-CoV-2, results were obtained in less than two hours without the need for a fully equipped laboratory, a factor consistent with the economic rationale of decentralised in-hospital diagnostics. [1] This does not mean that every point-of-care platform automatically generates savings; however, it does mean that the economic value of multiplexing should be assessed where it truly makes a difference: reduced turnaround time, rapid triage, fewer delays in decision-making and a reduced workload for the central laboratory.[2][4]

Traditional diagnostics still appear to offer advantages in terms of the unit cost of individual tests, particularly when considering culture or single-target PCR. However, when the clinical picture requires the simultaneous investigation of multiple pathogens, or when the result must rapidly alter patient management, the economic comparison should shift from the cost per individual analyte to the cost per clinical decision reached.[3]

The review by Serapide et al. highlights this point clearly: culture-based methods can take 48–72 hours, whereas multiplex PCR provides a useful result within a few hours and offers broader coverage than single-target tests. [3] Furthermore, in practical terms, the centralised laboratory adds transport, acceptance, batching and report issuance times to the analytical time.[2] It is precisely here that a significant proportion of hidden costs arises, because the department continues to make decisions under conditions of uncertainty.

The impact of time is clearly evident in the COV-19POC study by Brendish et al.: the median time to result was 1.7 hours with molecular point-of-care testing, compared with 21.3 hours with centralised laboratory PCR. [4] Even without going into the specifics of the individual device studied, the economic message is clear: when the result is available within the same clinical window, the test can influence isolation, patient allocation, bed usage and the appropriateness of the care pathway.

This is why decentralised multiplex testing tends to be more cost-effective precisely in settings where the range of possible causes is broad and time is of the essence: A&E departments, emergency medicine, acute care wards, respiratory epidemic seasons, and hospitals without permanent in-house molecular testing capacity. In these settings, the higher cost per test can be offset by a reduction in downstream costs, whilst a simple comparison between ‘rapid antigen tests and traditional tests’ risks being misleading.[2][3][4]

The return on investment for a decentralised multiplex qPCR platform depends on three key factors: test volumes, clinical and organisational pressure, and the ability of the results to influence the patient’s care pathway in a timely manner. The available evidence shows that, when these conditions are met, the financial benefits can be substantial.

In the decision-making model published by Diel and Nienhaus on the German hospital setting, the introduction of a point-of-care PCR test for SARS-CoV-2 in the A&E department resulted in an average saving of €107 per patient compared with a strategy based solely on clinical judgement followed by external PCR testing. The same study also estimates that the immediate exclusion of infection in patients admitted for other acute conditions could prevent a loss of revenue of €735 per patient.[5] Beyond the specific case of COVID-19, this figure is significant because it clearly shows where the ROI is generated: not in the reduction of the pure analytical cost, but in the mitigation of hospital inefficiencies caused by waiting times.

A second example comes from the model by Rahamat-Langendoen et al. on patients with suspected influenza or RSV. In this study, 54% of patients tested negative and, of these, 79% were nevertheless kept in isolation whilst awaiting the result, for a median duration of 24 hours. The introduction of point-of-care molecular testing would have reduced the average in-hospital cost per patient from €5,243 to €4,904 in the conservative scenario and to €4,206 in the most favourable scenario, with a total seasonal reduction of between €95,937 and €293,471 per hospital. [6] This is a prime example of how savings arise from the interaction between testing, isolation and flow management, not from diagnostics alone.

These studies highlight a useful criterion for internal evaluation: economic sustainability should be estimated as the ‘cost avoided per care episode’, rather than simply as the difference between the cost of the test kit and the cost of the laboratory test. If the rapid test reduces unnecessary hours of isolation, days spent in hospital, inappropriate admissions or transfers between clinical departments, its real economic value may be much greater than its nominal price.[5] [6]

The clinical benefits of decentralised multiplex diagnostics translate into economic gains in three main areas: shorter hospital stays, improved management of isolation, and a more targeted use of treatments and resources.

In the study by Melhuish et al., which looked at adults with community-acquired influenza assessed in A&E, patients tested using molecular POCT incurred costs that were 67% lower on average than those in the control group, with an average saving of £2,066 per patient. The authors attribute these savings to more targeted treatment, fewer hospital admissions and shorter lengths of stay. [7] This is a key point: the economic value of rapid testing becomes apparent when the result changes clinical management.

The ResPOC randomised trial, also conducted by Brendish et al., found that the routine use of molecular point-of-care testing for respiratory viruses was associated with a shorter average hospital stay – 5.7 days compared with 6.8 days – as well as more appropriate use of antivirals in patients with influenza and a higher frequency of very short or single-dose courses of antibiotics. [8] Here too, the economic benefit does not stem from a supposedly ‘cheaper test’, but from the improved quality of clinical decision-making.

A similar finding is observed in the paediatric study by Kitano et al. in Japan. In a comparison between rapid antigen testing and multiplex PCR panels in paediatric admissions for respiratory infections, the number of days of antimicrobial therapy per case fell from 12.82 to 8.56, the length of stay from 8.18 to 6.83 days, and the total cost of admission from 258,824 yen to 243,841 yen per case. [9] The pathogen identification rate also rose from 30.2% to 87.2%.[9] In economic terms, this reinforces a very concrete principle: improved diagnostic performance reduces clinical uncertainty and makes hospitalisation more efficient.

The available literature does not provide a single ‘universal’ figure for cost savings, as the result depends on the setting, the patient mix and the benchmark used. However, there is a fairly clear consensus on the direction of the effect.

A classic but still instructive example is that of Mahony et al., who compared four diagnostic strategies for paediatric respiratory infections. In the decision-making model, the multiplex panel alone proved to be the least expensive strategy when the prevalence of infection was at least 11%, with a cost per case of 3,623 Canadian dollars compared to 3,914 dollars for the DFA plus shell vial culture strategy. The estimated saving was CAD 291 per case, equivalent to CAD 529,620 per year across four hospitals and 1,820 paediatric admissions.[10] Although this is an older study, it remains useful because it clearly demonstrates the economic rationale for the multiplex panel when the range of suspected causes is broad.

A second case, more relevant to current practice, is the study by Kitano et al. mentioned earlier, which demonstrates that switching from rapid antigen tests to a molecular multiplex panel can be associated with lower hospitalisation costs, reduced use of antimicrobials and shorter hospital stays in a community hospital.[9]

A third study is that of Melhuish et al., which is particularly significant because it is based on actual individual costing, not merely on modelling. Here, the economic value of the rapid test is directly evident in the A&E setting, that is, at the point where the hospital faces the greatest tension between patient flow pressures and the need for rapid decision-making.[7]

These examples suggest that the correct question is not whether decentralised multiplex testing costs more, but in which scenarios and at what volumes it generates the greatest cost savings. The more time-sensitive the department is, the more the benefits tend to favour molecular point-of-care testing.[5][6][7][8][9][10]

In the context of Helyx Industries S.p.A.’s rebranding, the rationale behind this approach is clear: the economic viability of multiplex diagnostics in hospitals depends not only on the portability of the hardware, but also on the ability to reduce logistical and clinical downtime. For this reason, the article is consistent with the Vytro Division, which oversees multiplex solutions for clinical settings, whilst the Hyris System™ platform can, where relevant, serve as the distributed technological foundation supporting the model.

In a public hospital, the value of a decentralised platform is particularly evident when the central laboratory is not available on a continuous basis or operates in batches, when a suspected diagnosis requires testing for multiple targets simultaneously, when the result must guide decisions on isolation, admission, antivirals or antibiotics within a few hours, and when pressure on bed capacity makes any delay in decision-making costly. In these scenarios, decentralised multiplexing ceases to be a ‘premium’ technology and becomes a tool for efficiency. The economic assessment must therefore be based on the entire process chain: testing, time, bed availability, isolation, treatment, logistics, laboratory workload, and the speed of discharge or correct patient allocation.[2][4][5][6]

The available evidence consistently suggests that decentralised multiplex diagnostics can generate a real economic benefit for hospitals, particularly when introduced in settings where diagnostic turnaround time is critical. The benefit does not stem from the fact that the test costs less in absolute terms, but from the fact that it reduces the costs caused by waiting: unnecessary isolation, longer hospital stays, avoidable admissions, delays in treatment, ward transfers and laboratory inefficiencies.[5][6][7][8][9][10]

The key point, therefore, is to shift the focus of the discussion from the cost of the test to the cost of the entire process. If the result arrives too late to influence a decision, even a low-cost test can be inefficient. If, on the other hand, the result arrives within the relevant timeframe and actually leads to a change in management, then even a test that is more expensive per unit may prove to be the more cost-effective option.[4][5][7][8]

For Helyx Industries S.p.A., and in particular for the Vytro Division, this means that the value of multiplex diagnostics in hospitals must be justified on the basis of both industrial and hospital logic: less logistical friction, faster decision-making, and greater efficiency in the care pathway. It is in this area, rather than solely on the price of the reagent, that the economic impact of multiplex diagnostics in hospitals is determined.